Key result
Rectal stimulation and straining at stool invariably induced Stokes-Adams attacks featuring ventricular tachycardia or fibrillation in a patient with complete heart block.
This case report highlights that vagal stimulation via rectal manipulation can trigger life-threatening arrhythmias (Stokes-Adams attacks) in patients with complete heart block.
Caution advised during rectal procedures in complete heart block; single case leaves open generalizability and need for validation.
This paper reports a case of complete heart block whose Stokes-Adams attacks were induced by straining at stool and invariably by digital stimulation of the rectum. Electrocardiograms during attacks exhibited high ventricular tachycardia or fibrillation and chaotic heart action.
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Scott et al. (1950) studied this question. Rectal stimulation and straining at stool invariably induced Stokes-Adams attacks featuring ventricular tachycardia or fibrillation in a patient with complete heart block.
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